LONG-TERM EFFECTS OF RECOMBINANT-HUMAN-ERYTHROPOIETIN ON MACROCIRCULATION AND MICROCIRCULATION IN CHRONIC-HEMODIALYSIS PATIENTS

Recombinant human erythropoietin therapy (ReHuEpo) at short term leads to an increase in systemic vascular resistance and to a decrease in c ardiac index and skin microcirculatory flow. Long-term adaptive change s might occur. We studied the effects of ReHuEpo therapy on macrocircu lation and skin microcirculation in 8 normotensive and normovolemic he modialysis patients before and after, respectively, 4 and 14 months of treatment. The reported macrocirculatory changes at short term were a t long term not significantly different as compared with the initial v alues. The mean arterial pressure remained unaltered, as might be expl ained by the slow correction of the hematocrit and the decrease in car diac output in all initially long-lasting normotensive patients who we re maintained normovolemic. Left ventricular end-diastolic dimensions decreased, and also the left ventricular muscle mass decreased, depend ing on the initial left ventricular muscle mass. The skin oxygenation improved, whereas the maximal capillary flow decreased both at short- and long-term ReHuEpo treatment. The number of capillaries in the nail fold remained unchanged. However, the percentage of tortuosity decrea sed significantly during ReHuEpo therapy.